Individual provider Active NPI

John R Olson, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Columbia, TN
National Provider Identifier
1366488322
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD7578 Issued in TN
Practice address
1602 Hatcher LN
Columbia, TN 38401-4827
Phone
(931) 388-0777
Fax
(931) 388-1548
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD7578 TN Primary

Addresses

Primary practice location

1602 Hatcher LN
Columbia, TN 38401-4827

Mailing address

1602 Hatcher LN
Columbia, TN 38401-4827
Phone (931) 388-0777

Other identifiers 3

IdentifierTypeStateIssuer
3031067OtherBLUE CARE/TN CARE
200288300MedicaidIN
3403473MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110822000447 TN Order and Referring Only - PathologyPractitioner - Pathology 8224011903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD7578TNMDAnatomic Pathology & Clinical Pathology Physician
7578TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ferrell, Olson, Pearson & Bramlett Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305849600000",
    "number": "1366488322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014827",
            "telephone_number": "931-388-0777",
            "fax_number": "931-388-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014827",
            "telephone_number": "931-388-0777",
            "fax_number": "931-388-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2011-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "MD7578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE/TN CARE",
            "identifier": "3031067",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200288300",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3403473",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.